Evaluating access to oral anti-diabetic medicines: A cross-sectional survey of prices, availability and affordability in Shaanxi Province, Western China

Autoři: Caijun Yang aff001;  Shuchen Hu aff001;  Yanbing Zhu aff003;  Wenwen Zhu aff001;  Zongjie Li aff001;  Yu Fang aff001
Působiště autorů: The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi’an, China aff001;  The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi’an, China aff002;  Department of Pharmacology, Health Science Center, Xi’an Jiaotong University, Xi’an, China aff003;  Shaanxi Food and Drug Administration, Xi’an, China aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223769



To assess the availability and affordability of oral anti-diabetic medicines in Shaanxi Province, Western China.


In 2015, the prices and availability of 8 anti-diabetic medicines covering 31 different dosage forms and strengths were collected in six cities of Shaanxi Province. A total of 72 public hospitals and 72 private pharmacies were sampled, using a modified methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Medicine prices were compared with international reference prices to obtain a median price ratio. For urban residents, affordability was assessed as the lowest-paid unskilled government workers to purchase cost of standard treatment in days’ wages; for rural residents, days’ net income was used.


The mean availabilities of originator brands (OBs) and generics were 34.3% and 28.7% in public hospitals, and 44.1% and 64.4% in the private pharmacies. OBs and the lowest priced generics (LPGs) were procured at 12.38 and 4.52 times the international reference price in public hospitals, and 10.26 and 2.81 times the international reference prices in private pharmacies. Treatments with OBs were unaffordable even for urban residents. The affordability of the LPGs was good, except for acarbose, repaglinide and pioglitazone.


Most anti-diabetic medicines cannot met the WHO’s availability target (80% availability) in Shaanxi Province. The high prices of OBs had severely influenced the affordability of medicines, especially for the rural residents. Effective policies should be initiated to ensure the Chinese people a better access to more affordable anti-diabetic medicines.

Klíčová slova:

Drugs – Global health – Health economics – China – Insulin – Medicine and health sciences – Salaries


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2019 Číslo 10
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